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Minnesota rates for HCPCS L5987

All lower extremity prostheses, shank foot system with vertical loading pylon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $7,244.36 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $4,677.35 / $7,244.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $8,709.64 / $12,882.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,918.31 / $8,709.64 / $8,709.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,197.01 / $32,359.37 / $77,624.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $11,481.54 / $12,882.50
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,118.86 / $32,359.37 / $61,659.50
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $13,803.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $8,709.64 / $15,848.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $3,890.45 / $9,549.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $5,128.61 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $4,365.16 / $10,232.93